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All about: horse chestnut

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Generic Name: horse chestnut (HORSE CHEST nut)
Brand Names: Venastat

What is horse chestnut?

The use of horse chestnut in cultural and traditional settings may differ from concepts accepted by current Western medicine. When considering the use of herbal supplements, consultation with a primary health care professional is advisable. Additionally, consultation with a practitioner trained in the uses of herbal/health supplements may be beneficial, and coordination of treatment among all health care providers involved may be advantageous.

Horse chestnut is also known as Aesculus hippocastanum, Cellu-Var, Variclear, Reparil, Varicare, Varicosin, VeinAway, Venastat, and others.

Horse chestnut has been used topically to cosmetically improve the appearance of varicose veins. It has also been promoted for relief of swelling or inflammation of joints, tendons, and muscles and hemorrhoids. Horse chestnut has been used orally to improve symptoms of fatigue, and pain, nighttime cramping, itching and swelling in the legs.

Horse chestnut has not been evaluated by the FDA for safety, effectiveness, or purity. All potential risks and/or advantages of horse chestnut may not be known. Additionally, there are no regulated manufacturing standards in place for these compounds. There have been instances where herbal/health supplements have been sold which were contaminated with toxic metals or other drugs. Herbal/health supplements should be purchased from a reliable source to minimize the risk of contamination.

Horse chestnut may also have uses other than those listed in this medication guide.

What is the most important information I should know about horse chestnut?

Do not use horse chestnut without first talking to your doctor if you have a history of blood clots, colitis or other stomach or intestine related illnesses, diabetes, heart disease, low blood pressure, kidney disease, liver disease, or poor blood circulation. Do not take aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Motrin, Advil, others), naproxen (Aleve, others), or ketoprofen (Orudis KT, others) while using horse chestnut. These drugs may increase the risk of bleeding while using horse chestnut.

Horse chestnut has not been evaluated by the FDA for safety, effectiveness, or purity. All potential risks and/or advantages of horse chestnut may not be known. Additionally, there are no regulated manufacturing standards in place for these compounds. There have been instances where herbal/health supplements have been sold which were contaminated with toxic metals or other drugs. Herbal/health supplements should be purchased from a reliable source to minimize the risk of contamination.

What should I discuss with my healthcare provider before using horse chestnut?

Do not use horse chestnut without first talking to your doctor if you have
  • a history of blood clots;

  • colitis or other stomach or intestine related illnesses;

  • diabetes;

  • vitamin K deficiency;

  • a bleeding or blood clotting disorder;

  • are taking a blood thinner such as warfarin (Coumadin);

  • heart disease;

  • low blood pressure;

  • poor blood circulation;

  • liver disease; or
  • kidney disease.

Horse chestnut may not be safe for use if you have any of the conditions listed above.

Before using horse chestnut, talk to your doctor, pharmacist, or health care professional if you have allergies (especially to plants, foods, medicines, dyes, or preservatives), have any medical condition, or if you take other medicines or other herbal/health supplements. Horse chestnut may not be recommended in some situations.

Do not use horse chestnut without first talking to your doctor if you are pregnant or could become pregnant. Horse chestnut may be harmful to an unborn baby. Do not use horse chestnut without first talking to your doctor if you are breast-feeding a baby. It is also not known whether horse chestnut will be harmful to a nursing infant. Horse chestnut is generally not recommended for use by children. Do not give any herbal/health supplement to a child without first talking to the child's doctor.

How should I use horse chestnut?

The use of horse chestnut in cultural and traditional settings may differ from concepts accepted by current Western medicine. When considering the use of herbal supplements, consultation with a primary health care professional is advisable. Additionally, consultation with a practitioner trained in the uses of herbal/health supplements may be beneficial, and coordination of treatment among all health care providers involved may be advantageous.

If you choose to use horse chestnut, use it as directed on the package or as directed by your doctor, pharmacist, or other healthcare provider.

Horse chestnut cream and gel is intended for external use only. Do not take it my mouth. Wash your hands before and after application of the topical product. Apply a thin layer of the medication to the affected area and rub it gently into the skin. Do not apply the product to the eyes, nose, mucous membranes, or broken skin.

Take the oral forms of horse chestnut with a full glass of water. Take oral horse chestnut after a meal to reduce the chance of stomach upset.

Standardized extracts, tinctures, and solid formulations of herbal/health supplements may provide a more reliable dose of the product.

Do not use different formulations (e.g., tablets, topical formulations, and others) of horse chestnut at the same time, unless specifically directed to do so by a health care professional. Using different formulations together increases the risk of an overdose of horse chestnut.

Store horse chestnut as directed on the package. In general, horse chestnut should be protected from light, heat, and moisture.

What happens if I miss a dose?

If you miss a dose of horse chestnut, skip the missed dose and take the next regularly scheduled dose as directed. Do not take a double dose of the product.

What happens if I overdose?

Seek emergency medical attention.

Symptoms of an horse chestnut overdose are not known.

What should I avoid while taking horse chestnut?

Do not take aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Motrin, Advil, others), naproxen (Aleve, others), or ketoprofen (Orudis KT, others) while using horse chestnut. These drugs may increase the risk of bleeding while using horse chestnut.

Horse chestnut side effects

Although uncommon, allergic reactions to horse chestnut have been reported. Stop taking horse chestnut and seek emergency medical attention if you experience:
  • an allergic reaction (difficulty breathing; closing of the throat; swelling of the lips, tongue, or face; or hives);

  • bleeding (gums, nose, skin, stool, urine);

  • decreased amounts of urine;

  • joint or muscle pain;

  • skin rash; or

  • unusual bruising.

Other less serious side effects have also been reported. Talk to your doctor or pharmacist if you experience

  • stomach upset or heartburn; or

  • burning or stinging where cream or gel is applied.

Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

What other drugs will affect horse chestnut?

Do not take horse chestnut with any of the following medications or herbal supplements:
  • aspirin;

  • a nonsteroidal anti-inflammatory drug (NSAID) such as ibuprofen (Advil, Motrin, others), naproxen (Aleve, Anaprox, Naprosyn, others), ketoprofen (Orudis, Orudis KT), diclofenac (Cataflam, Voltaren), nabumetone (Relafen), etodolac (Lodine), indomethacin (Indocin), piroxicam (Feldene), oxaprozin (Daypro), and others;

  • clopidogrel (Plavix);

  • cilostazol (Pletal);

  • dipyridamole (Persantine, Aggrenox);

  • warfarin (Coumadin);

  • heparin, dalteparin (Fragmin), danaparoid (Orgaran), enoxaparin (Lovenox), or tinzaparin (Innohep);

  • feverfew;

  • danshen;

  • garlic; or

  • ginger.

You may not be able to take horse chestnut, or you may require a dosage adjustment or special monitoring during treatment if you are taking any of the medicines listed above.

Drugs other than those listed here may also interact with horse chestnut. Talk to your doctor, pharmacist, or health care professional before taking any prescription or over-the-counter medicines or other herbal/health supplements.

Where can I get more information?

  • Your doctor, pharmacist, or health care provider may have more information about horse chestnut.

  • Consultation with a licensed health care professional is advisable before using any herbal/health supplement. Additionally, consultation with a practitioner trained in the uses of herbal/health supplements may be beneficial and coordination of treatment among all health care providers involved may be advantageous. Remember, keep this and all other prescription drug products, over-the-counter drug products, and herbal/health supplements out of the reach of children.
  • Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.
Copyright 1996-2006 Cerner Multum, Inc. Version: 1.04. Revision Date: 2/13/04 4:09:26 PM.

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